Federal Regulators Probe Multi-State Cyclosporiasis Outbreak

A multi-state food borne illness outbreak, tied to the cyclospora pathogen, is now under investigation by federal regulators. The cause of the outbreak has not yet been determined.

The U.S. Food and Drug Administration (FDA) is probing the intestinal infection; the U.S. Centers for Disease Control and Infection (CDC) and local and state officials are also looking at the outbreak that has sickened more than 200 people in at least four states, according to Reuters.

“As of July 18, 2013, CDC has been notified of more than 200 cases of cyclospora infection in residents of multiple states, including Iowa, Nebraska, Texas, and Wisconsin,” the FDA said in a statement. The agency also stated that it remains unclear if all of the illnesses are related to the same outbreak, according to Reuters. The cyclosporiasis outbreak is believed to be related to contaminated fruit and vegetables.

People can remain ill with cyclosporiasis, which is caused by the rare cyclospora parasite, for about two months. The food borne illness causes symptoms such as watery diarrhea, appetite and weight loss, cramps, bloating, gas, nausea, and fatigue. The disease can also lead to vomiting and low-grade fever in some cases, according to the CDC. CBS News points out that the diarrhea could last nearly 60 days without treatment, which is typically the combination antibiotic trimethoprim/sulfamethoxazole.

The Iowa Department of Public Health previously stated that people are reporting that they are either still ill or suffering from relapses, according to CBS News. In Nebraska, the state epidemiologist, Dr. Thomas Safranek, told the Associated Press (AP) that fresh and vegetables are the likely culprits; however, the investigation there continues.

Prior to 1996, cyclospora illnesses were only reported in people who traveled to developing countries or who suffered from weakened immune systems, according to the Mayo Clinic, CBS News reported. Even then, the cases were infrequent. Since 1995, lettuce, fresh basil, and imported raspberries have been blamed in North American cyclosporiasis outbreaks, the Mayo Clinic reports, noting that scrupulous washing cannot always eliminate the parasite.

Fruits and vegetables should be thoroughly washed, even fruit that has been peeled, prior to eating. Hands should be washed often and completely with hot water, most especially after using the bathroom, changing diapers, playing with or cleaning up after or working with animals, and after gardening, HumanIllness warns. Hands should also be washed before eating and unfiltered water from water sources such as lakes or rivers, should be avoided, even sparkling springs. Do not swallow water when swimming in lakes, rivers, swimming pools and spas; chlorine might not be sufficient to kill the parasites, according to HumanIllness.

Intestinal infections are among the most common sickness worldwide, notes HumanIllness. Annually, some 48 million Americans—about one in six people—are sickened due to consumption of contaminated food according to CBS News.

Cyclosporiasis is caused by ingesting food or water contaminated with a microscopic one-celled parasite, according to Reuters, and is more commonly seen in the world’s tropical and subtropical regions.